Dr Alfred Kow, Senior Consultant for Singapore’s National University Hospital’s Division of Hepatobiliary & Pancreatic Surgery in writing for the United Evening News on May 26, cited the case study of a 29-year-old patient who father was diagnosed with gall bladder cancer when he was about 40 years old.
Dr Kow explained that while most cancers are not related to genetics, those with a clear family history should take extra care. Likewise, gall bladder cancers are not mostly found in people with a family history of the disease.
A history of gallbladder cancer in the family seems to increase a person’s chances of developing this cancer, but the risk is still low because this is a rare disease.
Researchers have found some risk factors that make a person more likely to develop gall bladder cancer. They’re also learning more about how some of these risk factors might lead to gallbladder cancer.
The American Cancer Society says that chronic gall bladder inflammation is a common link among many of the risk factors for gallbladder cancer. For example, when someone has gallstones, the gallbladder may release bile more slowly. This means that cells in the gallbladder are exposed to the chemicals in bile for longer than usual. This could lead to irritation and inflammation.
In another example, defects in the ducts that carry fluids from the gall bladder and pancreas to the small intestine might allow juices from the pancreas to flow backward (reflux) into the gallbladder and bile ducts. This reflux of pancreatic juices might inflame and stimulate growth of the cells lining the gallbladder and bile ducts, which might increase the risk of gallbladder cancer.
Scientists are starting to understand how risk factors like inflammation might lead to certain changes in the DNA of cells, making them grow out of control and form cancers. DNA is the chemical in each of our cells that makes up our genes, the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than how we look.
- Some genes control when cells grow, divide into new cells, and die. These genes are called oncogenes.
- Genes that slow down cell division or cause cells to die at the right time are called tumor suppressor genes.
Cancer can be caused by DNA changes (mutations) that turn on oncogenes or turn off tumor suppressor genes. Changes in many different genes are usually needed for a cell to become cancer.
Some people inherit DNA mutations from their parents that greatly increase their risk for certain cancers. But inherited gene mutations are not thought to cause very many gallbladder cancers.
Gene mutations related to gallbladder cancers are usually acquired during life rather than being inherited. For example, acquired changes in the TP53 tumor suppressor gene are found in many cases of gallbladder cancer.
Other genes that may play a role in gallbladder cancers include KRAS, BRAF, and PIK3CA. Some of the gene changes that lead to gall bladder cancer might be caused by chronic inflammation. But sometimes the cause of these changes is not known. Many gene changes might just be random events that sometimes happen inside a cell, without having an outside cause.
There’s no known way to prevent most gall bladder cancers. Many of the known risk factors for gall bladder cancer, such as age, gender, ethnicity, and bile duct defects, are beyond our control.
But there are things you can do that might help lower your risk. Getting to and staying a healthy weight is one important way a person may reduce their risk of gallbladder cancer, as well as many other types of cancer.